Before the mid-2010s, most rural health policies and practices were presented as “race neutral,” focusing only on rural health as compared with urban. While rural communities are generally less racially and ethnically diverse than cities, rural Communities of Color have always existed and continue to grow. While specific studies on these disparities are still limited, the impact of generational racism on rural Communities of Color has been documented in lower rates of insurance and hospital access, reports of violence and harm within healthcare settings, higher rates of survival strategies such as smoking and substance use, and higher rates of specific forms of stress-related illness and disease.